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Diet In Fevers By Mumtaz Khalid Ismail
More Links Diet during acute fever Typhoid fever Chronic fever Fever in infants and children Points to note
Fever is an elevation of temperature above normal range, out come of an imbalance between the heat produced in the body and the heat eliminated from the body. The normal human body temperature is 37 degree centigrade (98.6-degree Fahrenheit). It is lowest in the morning and rises in the evening. A person can develop fever due to varied causes like infection (viral, bacterial or fungal), infestation, immune mediated, malignancy, drugs etc.
Fever could be of shorter duration - acute, or of a longer duration - chronic. Like wise it could be continuous or intermittent.
The diet should be more of fluid and at frequent intervals during the first two to three days of fever. The fluid intake must be liberal to compensate for the losses from the sweat and to permit adequate volume of urine for excreting the wastes. Milk, glucose water, soups, fruit juices and water can be included to meet this demand.
The calorie requirement may be increased as much as 50% if the temperature is high. It may be difficult to meet the calorie needs during the peak of the fever but a high calorie diet with frequent feeding should be given as soon as fever is controlled. The carbohydrate should consist of glucose, sucrose, and starch. Glucose, which is less sweet and readily absorbed into the blood stream, is preferred. For starch, cereal and cereal grains cooked into gruel and pudding to be given to the patients. Fats in the form of butter, ghee, vegetable oil, and fried food should be avoided during fever.
Protein intake is also increased to 50% in excess of the daily requirement due to the increased loss of tissue proteins during fever. The protein should be of high nutritive value and easily digestive such as milk, egg, and moong dhal. High protein beverages are preferred to the regular meals. Fever increases the requirement for vitamin A, ascorbic acid, calcium, phosphorous, sodium and B complex vitamins.
Liberal intake of milk, fruits, fruit juices and two or three eggs will take care of the above requirement. As soon as the temperature comes down readily digestible bland food should be given to the patient for better digestion and rapid absorption depending on the patient's need the food can be soft or normal consistency. Initially the interval of feeding should be 2 hours. Later on improvement it can be made into 4 hours interval or 4 meals a day.
Typhoid fever is an infectious disease with a characteristic pattern of acute fever. The disease is usually transmitted by contaminated food. A high calorie, high protein, high carbohydrate, low fat, high fluid, low fibre, and bland diet is advisable for typhoid patients. Since typhoid fever is associated with intestinal inflammation, diet should preferably free of spices and fibres. Refined cereals, eggs, boiled potato, simple desserts like custard, and porridge should be given.
Foods should be included Fruit juices Glucose water Milk Coconut water Barley water Custards Thin dhals Eggs Gruel's Vegetable juices Soups Cereal preparations Tender meat, baked fish
Foods should be avoided Butter Ghee Vegetable oil Irritating fibrous foods Fried foods Rich pastries Rich puddings Highly spiced preparations Strongly flavoured beverages Cream soups
- Patients will have poor appetites and food must be appetising and according to the patients likes and dislikes.
- The first two or three days the diet should be more of fluid and of small feeds given at frequent intervals.
- High calorie, high protein, liberal amounts of fluid and vitamins and minerals should be given.
- The fluid intake must be liberal to compensate for the losses from the sweat and to permit adequate volume of urine for excreting the wastes. Milk, glucose water, soups, fruit juices and water can be included to meet this demand.
- The protein should be of high nutritive value and easily digestive such as milk, egg, and moong dhal.
- Fatty foods, highly fibrous foods, and spicy foods that are hard to digest should be avoided.
- Fevers increase the requirement for vitamin A, ascorbic acid, calcium, iron, phosphorous, sodium and B complex vitamins.
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A high calorie and high protein (80-120 gm per day) should be given. This minimises weight loss, which is quite common in chronic fever. Mineral calcium should be provided liberally since it is essential for the healing of tuberculosis lesions. At least a litre of milk should be consumed daily. Iron supplementation may be necessary if one suffers from haemorrhage. The vitamin A metabolism is adversely affected in tuberculosis so vitamin A rich foods such as carrot, tomato, papaya, mango, green leafy should be included in the diet. Another important vitamin deficiency associated with this condition is that of vitamin C. Vitamin C is essential for many regenerative purposes. An additional amount of citrus fruits such as orange, sweet lime, lemon, goose berry or ascorbic acid supplementation is essential.
